How the Most Bizarre and Offensive Reality TV Show of All Time Got Made

FOX's 'The Swan' chronicled 16 women as they underwent extensive plastic surgery and weeks of intensive therapy. Over a decade later, the key players involved with the reality TV show look back at what made the show so particularly surreal.

The history of reality TV is littered with bad ideas, tasteless concepts, and shows designed to make viewers watch because they can't turn away from the ugliness. But even among the genre's trashiest programs, The Swan, which ran for two seasons on FOX in 2004, stands out as a particularly controversial low. It was basically a beauty pageant with a twist: All the contestants were "ugly ducklings" who would be transformed with the help team of three surgeons, a cosmetic dentist, therapist, trainer, stylist, and life coach. The premise was self-actualization by way of a scalpel, and it's remembered today with horror.

The Swan was supposed to cash in on the trend of sleazy reality shows like Extreme Makeover and The Bachelorette, but though the show was a hit, averaging 9.1 million viewers a week, it was also reviled by critics—USA Today called it "hurtful and repellent." Its reputation remains toxic, with one contestant writing a tell-all memoir slamming her experience; others have gone on record describing the ordeal as "absolute shit" that left them literally and figuratively scarred once production wrapped.

Though the show is remembered for its most shocking element, namely the extensive and accelerated use of plastic surgery, it was the contestants—16 in each season—who were really at the show's center, all at the end of their rope, desperate for change.

"The common denominator was that they were all stuck," Shelia Conlin, the show's casting directory, told VICE. "They felt they'd tried everything and didn't know what else to do. It couldn't just be [someone saying], 'I've always wanted bigger boobs or a nose job.' We had to know what [The Swan] really meant to them."

Cindy K. Ingle, now 45, went into The Swan wanting a tummy tuck, a breast job, and a new nose job to fix an issue from a prior one. By the time the show's finale aired two years later, she would be crowned second runner-up.

"I wanted so much stuff done, but I knew I couldn't get it on my own," Ingle recalled in an email to VICE. "This is what I needed to get on the right track. I figured I just need that jump start and then I could take care of it, emotionally and physically, for the rest of my life."

But while the women in front of the camera were eager, many of the professionals tasked with bringing them across the finish line remained skeptical of the show's transformative power.

"Reality TV is a slippery slope," said Randal Hayworth, a Beverly Hills-based plastic surgeon who was hired to be one of the show's in-house surgeons. During filming, Hayworth felt that the producers stifled his professional opinion in favor of what would make for good TV.

"You couldn't really express your actual feelings," he said of his time on camera."I was censored in saying things I actually thought. Instead of expressing different ways of thinking about the process or patients, they had us saying the same thing repeatedly." Hayworth specifically remembers instances in which producers would ask the surgeons to repeat the same comments to multiple contestants, often eliminating nuances or differences among the patients and their surgeries.

The producers also got psychologist Lynn Ianni to work with the women on-camera during their cosmetic recovery to build up their self-esteem and break down past traumas. During the six months of season one's filming, she conducted therapy sessions with each of the contestants twice a week. Though she knew to focus on what made each woman unique—where these women came from, the baggage they carried with them, the fears they had going forward—Ianni worried the rushed production wouldn't allow for enough time.

"I knew that I didn't have any creative control in the cutting room," Ianni said during a phone interview. "So the most important thing to me was that the girls feel really good about the work they'd done. My focus was to make sure it was going to be real, about helping and not sensationalizing."

Ianni was in many ways the most controversial part of the show. Jennifer Pozner, author of Reality Bites Back, a critical analysis of reality TV, cites Ianni and the show's flippant use of therapy as the single element that pushed The Swan past its contemporaries in both tastelessness and long-term danger. That the filmed therapy sessions attempted to go deeper than just appearances, while still explicitly stating or implicitly enforcing traditional beauty standards, was, in Pozner's estimation, the worst of the show's many grievances.

"The real depths of exploitation were in that psychological element," Pozner explained, "and that [Ianni] wasn't even licensed by an accredited institution." Ianni had completed her PhD in Clinical Psychology at California Coast University, which the show's critics are quick to point out is an online-accreditation program.

"I worked with the girls to the best of my ability," Ianni said. "We tried to go back to figure out their triggers and give them a new way to see themselves, so that by the time they shifted physically, they already felt different emotionally."

"These women were suffering from trauma that could not be fixed by a tummy tuck." — Jennifer Pozner, author of 'Reality Bites Back'

In an interview with The Huffington Post nearly ten years after the show aired, season two contestant Lorrie Arias blamed the series for her subsequent depression, bipolar, and body dysmorphia. Though she praised Hayworth's surgery work, she claimed that the show's deceptive use of behavioral and emotional therapy created more long-lasting problems than it did solutions. With no follow-up therapy sessions, the women were left to acclimate to the world at large with a new face and no support. Arias, who could not be reached for comment, said in the past interview that she still suffer from agoraphobia.

"These women were suffering from trauma that could not be fixed by a tummy tuck," says Pozner. "They had been actively victim abused by men, had battered women syndrome, they felt unworthy of living, and they were the ones chosen."

Some people involved in the show still defend it today. Even with his reservations, Hayworth still defends the process, and says the women were "adultsincapable of having been taken advantage of." Conlin, the casting director, commends the show for having helped de-stigmatize plastic surgery. Season one winner, Rachel Love, called contestants who criticized The Swan"crybabies." And Ingle, the runner-up, told me she would do it all over again.

"I came out of the show an improved me," Ingle said. "I was and still am happy with the results. I turn heads, I get complimented. There is nothing negative with my experiences to speak of."

Conlin is confident that The Swan could air today ("You have a younger generation getting boob jobs by 18," she said), and, for better or worse, Pozner seems to agree. "Misogyny is cooked right into the DNA of reality TV," she said, "so I think the show would maybe even last longer today."